Efeitos da laserterapia na função mastigatória e nos movimentos mandibulas de indivíduos adultos com DTM: uma revisão sistemática com metanálise

Abstract

Introduction: Temporomandibular dysfunction (TMD) is a complex disorder that involves a set of disorders that affect the muscles of mastication, such as temporomandibular joints and associated structures, which can cause damage to masticatory function and jaw movements. The main signs and symptoms of TMD are the limitation of mandibular movements, tenderness in the masticatory muscles, joint noises, orofacial pain and headache. Among the various treatments that can be used in the intervention of pathology, one of the most used non-invasive therapies is the Low Power Laser (LBP), which has been bringing satisfactory results due to the benefits provided to patients through their analgesic, anti-inflammatory and regenerative actions Objective: perform a systematic review of the effects of laser therapy on masticatory function and jaw movements in adults with TMD. Methods: This is a systematic review under registration number CRD42020187091. A search was made in the electronic databases PubMed, Web of Science, Scopus, Embase, Cochrane, Lilacs, Science Direct and Google Scholar. A search strategy was used, according to the Mesh Terms of PubMed and Decs of the VHL, with the descriptors: “temporomandibular joint disorders” AND “low level light therapy” OR “low level laser therapy” AND “mastication” OR “ mandible ”. Randomized clinical trials were included in adults diagnosed with TMD, whose therapeutic approach adopted was the Low Power Laser (LBP) and evaluation of masticatory and / or mandibular function, as analyzed outcomes. Results: 914 articles were identified in the databases and after removing the duplicates, 63 remained for later reading of the title and abstract, and then the full text. 52 studies were removed, leaving 10 articles for extraction and qua analysis of the data. After analyzing the included studies, it was found that the research had very different results, especially with regard to the oral amplitude variable. And in assessing the risk of bias, 6 studies were at high risk, 2 at uncertain risk and 2 at low risk of bias, demonstrating a low methodological quality of the articles. Conclusion: Bearing in mind that only one study addresses the masticatory function, it is shown that there is a shortage in the literature regarding the analysis of this variable and with regard to the maximum oral amplitude, researches are very variable as to the methodological parameters used and intended outcomes. Therefore, there is not enough information to carry out an analysis as to the effects of LBP photobiomodulation therapy on chewing. In the mandibular function, it was noted that in the intervention groups, Photobiomodulation with LBP showed significant results mainly for the outcome of oral amplitude.